Helping you get the measure of workplace rehabilitation Self-assessment of workplace rehabilitation A checklist for employers About the self-assessment of workplace rehabilitation >> The workplace rehabilitation environment >> Checklist for individual worker’s ﬁle >> Get the measure >> References >> About the self-assessment of workplace rehabilitation General information The objective of workplace rehabilitation is to manage employees’ recovery from injury in such a way that they can return quickly and safely to their pre-injury employment wherever possible. The workplace rehabilitation process for injured employees should be managed in a way that is inclusive, respectful and considerate of individual needs. For many injured workers, workplace rehabilitation will consist of medical and allied health treatment with a short period of suitable duties as part of a graduated return to work. Serious or complex injuries will require more comprehensive management and employers should work closely with their workers’ compensation insurer and the treating medical practitioner in these cases. The use of the self-assessment checklist is voluntary. The self-assessment checklist was developed to provide a framework for those employers who wish to assess their workplace rehabilitation systems for the purpose of continuous improvement. As workplace rehabilitation has a crucial role in reducing the cost of workplace injury, it is important for employers to identify where to focus their efforts in improving workplace rehabilitation processes and procedures to achieve continuous improvements in outcomes. The self-assessment checklist is intended to assist employers to assess their performance over several key categories related to the provision of workplace rehabilitation. The categories include legislative obligations as set out in the Workers’ Compensation and Rehabilitation Act 2003 and the Workers’ Compensation and Rehabilitation Regulation 2003 (Queensland). Best practice indicators developed from various sources in the rehabilitation literature (see References at the end of this document) are also included. Who will beneﬁt from using the self-assessment checklist? • Q-COMP developed the self-assessment checklist to assist employers, rehabilitation and return to work coordinators and injury management advisors to assess their performance on key categories of workplace rehabilitation. It includes legislative and regulatory requirements and commonly accepted principles of good practice. • The self-assessment checklist should not be considered exhaustive and employers should consider adding additional indicators to customise the self-assessment checklist for their particular circumstances. • Use of the self-assessment checklist in developing a continuous improvement program for workplace rehabilitation is voluntary. 2 About the self-assessment of workplace rehabilitation How to use the self-assessment checklist • By using the self-assessment checklist, employers should be able to assess their workplace rehabilitation systems on a range of categories and elements separated into workplace rehabilitation system speciﬁc issues and issues relating to the management of rehabilitation at the individual worker level. • Following completion of Section One, the assessor should select a random sample of workplace rehabilitation ﬁles to assess the management of each individual workers’ rehabilitation using the self-assessment checklist in Section Two. • Administration of the self-assessment checklist should preferably be carried out by an individual with an understanding of the principles of workplace rehabilitation and some practical experience in the ﬁeld. • Smaller employers with a limited claims history may choose to assess all rehabilitation ﬁles. • The self-assessment checklist should be used by the employer as an internal review tool and should be retained by the employer. It is not required that the completed self-assessment checklist be returned to Q-COMP. • Larger employers should ensure that the population from which the sample is to be randomly selected represents a relevant population that will provide a meaningful sample to test for compliance with the categories and elements set out in the self-assessment checklist. • The self-assessment checklist is designed to provide employers with a knowledge of basic principles of good practice and to assist them to gain a snapshot of how their system and processes are working in practice. • Assessors will be able to see at glance which elements show evidence of compliance or non-compliance. Partial compliance or other comments can also be indicated in the Comments/action required column. • It is intended that the self-assessment checklist will highlight areas of performance/compliance and non-performance/non-compliance. • A space is provided after each category to record more extensive notes or comments. • The self-assessment checklist is divided into two sections: • Following completion of the self-assessment checklist, a performance summary report and an improvement action plan should be developed. » » Section One The workplace rehabilitation environment; and Section Two Checklist for individual worker’s ﬁle. • Section One is designed to assess the environment for workplace rehabilitation while Section Two is designed to be used in assessing individual workers’ rehabilitation ﬁles. • The assessor should ﬁrst work through all the workplace rehabilitation categories in Section One, progressively examining each element and indicating evidence of compliance by ticking the box or non-compliance by leaving the box blank. An assessment of provided may be indicated if one or more items of evidence are present. • The performance summary report and the improvement action plan should identify opportunities for improvement in performance. The performance summary report should also identify successful strategies and achievements in workplace rehabilitation. • The improvement action plan should detail issues for improvement, the proposed actions to be taken, the timeframes for action and responsibilities for action. Actions should be implemented within a reasonable time after completing the self-assessment checklist. 3 Section one The workplace rehabilitation environment Category one Return to work culture Commitment of staff at all levels is crucial if workplace rehabilitation is to be effective. The intent of this category is to assess if there is management and worker commitment for workplace rehabilitation. Key elements Evidence of veriﬁcation - one or more may be used Workplace rehabilitation policy is dated, current, signed by CEO or other responsible ofﬁcer and has a review date CEO or ofﬁcer signature, date and review date Clearly documented workplace rehabilitation procedures Published and displayed at workplace Staff responsible for accident reporting also report to the rehabilitation and return to work coordinator Case notes Notiﬁcation forms Other evidence Policy and procedures are part of induction Included in induction material, programs Awareness of all workers of workplace rehabilitation Policy statement of commitment displayed at the workplace Policy discussed at work group meetings Evidence of ongoing education related to workplace rehabilitation Minutes of staff meetings Posters Newsletters Memos Trained rehabilitation and return to work coordinator nominated Name of rehabilitation and return to work coordinator shown on: • policy • noticeboards Nominated rehabilitation and return to work coordinator has sufﬁcient seniority and relevant skills to successfully undertake the role Nominated rehabilitation and return to work coordinator is allocated sufﬁcient time for performance of the role Position description includes duties of the rehabilitation and return to work coordinator Key performance indicators for the role include workplace rehabilitation Identiﬁcation of a person or organisation that can provide advice on workplace rehabilitation Documents showing: • contact details for persons or organisations • employee assistance program documentation Tick if provided Comments/action required 4 Section one The workplace rehabilitation environment Category one Return to work culture Key elements Evidence of veriﬁcation - one or more may be used Business performance in relation to workplace rehabilitation is measured Rehabilitation performance reported in management reports and statistics Line manager and senior management responsibility for workplace rehabilitation is reﬂected in position description Position description Workplace rehabilitation policy and procedures are reviewed at regular intervals or at intervals required by legislation Records of reviews Revised policy or procedure documents reﬂect outcomes of the review Workers or their representatives involved in development and review of the workplace rehabilitation system Consultative arrangements documented in minutes, correspondence, etc. Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category one under the workplace rehabilitation environment Notes: 5 Section one The workplace rehabilitation environment Category two Conﬁdentiality Trust and cooperation are integral to successful workplace rehabilitation. It is important that information gathered during workplace rehabilitation is used only for the purpose for which it was intended. Employers and rehabilitation and return to work coordinators would normally only seek information related to capacity for work or level of function. The intent of this category is to assess whether information obtained during the workplace rehabilitation process is at all times treated with conﬁdentiality and sensitivity by all parties. Information collected during workplace rehabilitation should not be used to disadvantage the injured worker. For example, medical information collected during workplace rehabilitation is subject to privacy principles and anti-discrimination legislation and should only be used for the purpose for which it was collected. The injured worker’s authority is not required for release of information to the insurer or to Q-COMP. However, an authority must be obtained by the rehabilitation and return to work coordinator to obtain or release information to any other person related to the worker’s current workplace injury. Key elements Evidence of veriﬁcation - one or more may be used There is a clear policy governing privacy in respect to return to work and rehabilitation Privacy policy included in workplace rehabilitation policy and procedures Appropriate safekeeping implemented for all ﬁles Rehabilitation ﬁle kept secure and separate from human resource ﬁle Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category two under the workplace rehabilitation environment Notes: 6 Section one The workplace rehabilitation environment Category three Evaluation of workplace rehabilitation The intent of this category is to assess whether workplace rehabilitation is effective. The evaluation assesses the success rate of individual programs, costs and durations, problems or issues of concern, positive outcomes and injured workers’ satisfaction. Key elements Evidence of veriﬁcation - one or more may be used Database of all claims is maintained showing costs, duration, injury type, outcomes Database of all claims showing costs, duration, injury type, outcomes System of workplace rehabilitation is reviewed/audited/selfassessed regularly and the results documented Reports noting performance on a range of indicators such as cost, duration, return to work status, services provided, regular reports to senior management Reviewers/assessors are independent of the area being audited/ assessed Assessment reports demonstrate appropriate selection of assessors/reviewers Deﬁciencies are highlighted in review/assessment and are addressed and monitored for improvement Action/improvement plan on ﬁle Plan implemented and monitored as shown in reports to management System for processing issues/complaints raised by injured workers in relation to rehabilitation in place Issues/complaints system (e.g. Australian Standard 4269) Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category three under the workplace rehabilitation environment Notes: 7 Section two Checklist for individual worker’s ﬁle This section can be copied and used as a self-assessment checklist for multiple workers’ ﬁles Employer Date of assessment Name of assessor Name of worker Claim number Date of injury dd/mm/yyyy dd/mm/yyyy Nature of injury 8 Section two Checklist for individual worker’s ﬁle Category one Return to work culture Commitment of staff at all levels is crucial if workplace rehabilitation is to be effective. The intent of this category is to assess if there is a culture of commitment for workers undertaking workplace rehabilitation. Key elements Evidence of veriﬁcation - one or more may be used Rehabilitation does not disadvantage the injured worker Injured worker was not dismissed due to injury Tick if provided Comments/action required Workers are able to nominate a person to support and assist with Case notes show worker was made aware of this workplace rehabilitation matters In the event of a dispute, the worker is made aware of the grievance mechanism/process Documented evidence on rehabilitation ﬁle that injured worker was made aware of procedures at time of dispute Add up the total number of ticks, enter in the box, then click here to enter your score in category one under checklist for individual worker’s ﬁle Notes: 9 Section two Checklist for individual worker’s ﬁle Category two Conﬁdentiality Trust and cooperation are integral to successful workplace rehabilitation. It is important that information gathered during workplace rehabilitation is only used for the purpose for which it was intended. Employers and rehabilitation and return to work coordinators would normally only seek information related to capacity for work or level of function. The intent of this category is to assess whether information obtained during the workplace rehabilitation process is at all times treated with conﬁdentiality and sensitivity by all parties. Information collected during workplace rehabilitation should not be used to disadvantage the injured worker. For example, medical information collected during workplace rehabilitation is subject to privacy principles and anti-discrimination legislation and should only be used for the purpose for which it was collected. The injured worker’s authority is not required for release of information to the insurer or Q-COMP. However, an authority must be obtained by the rehabilitation and return to work coordinator to obtain or release information to any other person related to the worker’s current workplace injury. Key elements Evidence of veriﬁcation - one or more may be used Rehabilitation and return to work coordinator obtained injured worker authority to liaise with treating doctor Copy of signed authority on injured worker’s ﬁle Authority sent to treating doctor Rehabilitation and return to work coordinator obtained injured worker authority to liaise with treating allied health and other providers Copy of signed authority on injured worker’s ﬁle Authority sent to provider Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category two under checklist for individual worker’s ﬁle Notes: 10 Section two Checklist for individual worker’s ﬁle Category three Planning This category assesses whether basic planning for workplace rehabilitation and return to work strategies is being provided at the workplace. A rehabilitation and return to work plan is required for workers undertaking rehabilitation. Where this occurs, the employer and rehabilitation and return to work coordinator should liaise with the insurer. The insurer’s case manager will work with the injured worker, employer and rehabilitation and return to work coordinator to develop a comprehensive rehabilitation and return to work plan. Key elements Evidence of veriﬁcation - one or more may be used Evidence of planning for all workers undertaking rehabilitation Suitable duties plan on ﬁle Case notes on injured worker’s ﬁle Plan has a goal and strategies for achieving the goal Suitable duties plan on ﬁle Planning identiﬁes actions and responsibilities Suitable duties plan shows actions and person responsible Plan developed in consultation with treating doctor Treating doctor signature on plan (if required) Consultation documented in case notes Plan developed in consultation with injured worker Injured worker signature on plan Consultation documented in case notes For complex or serious injuries, the insurer case manager is consulted Case notes Copy of suitable duties plan forwarded to insurer case manager Regular and appropriate contact is maintained with injured worker Case notes Plan is reviewed regularly Case notes File reviews Case conference notes Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category three under checklist for individual worker’s ﬁle Notes: 11 Section two Checklist for individual worker’s ﬁle Category four The return to work process The National Occupational Health and Safety Commission (NOHSC 1995) describes workplace rehabilitation as a managed process involving early intervention with appropriate, adequate and timely services based on assessed needs, which is aimed at maintaining injured or ill employees in, or returning them to, suitable employment. The intent of this category is to ensure that intervention is timely and appropriate and that adequate documentation of the rehabilitation process is maintained. 4a Early intervention Early contact and intervention is vital in promoting and maintaining a positive relationship between the injured worker and the workplace. It also assists in promoting workplace rehabilitation. Key elements Evidence of veriﬁcation - one or more may be used Early contact with worker following injury to show support and advise of entitlements and procedures for rehabilitation Case notes Other documentation Assistance to injured worker to complete application for compensation, if required Case notes Early and proactive contact with treating doctor to assess the potential of the injured worker to return to work Case notes Fax Emails Correspondence Report from doctor Management and staff made aware of their responsibilities and procedures at time of injury Case notes Copies of memos Emails Initial assessment by rehabilitation provider considered when: • Estimated loss of function > 4 weeks • Serious injury • Aggravation or injury during suitable duties • Complications with injury • No suitable duties available • No progress towards return to work Note: may require insurer approval in some circumstances Case notes Letter of referral Reports from provider/s Tick if provided Comments/action required 12 Section two Checklist for individual worker’s ﬁle Category four The return to work process 4a Early intervention continued Key elements Evidence of veriﬁcation - one or more may be used Injured worker aware of the role of the insurer case manager at time of lodging claim Induction material Case notes Emails Correspondence Contact with insurer case manager as appropriate to update case manager on progress and discuss any difﬁculties, concerns or suggestions Case notes Fax Emails Reports Provide insurer with copies of any reports or progress reports from providers to avoid duplication and keep insurer informed Case notes Fax Emails Correspondence Reports Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category 4a under checklist for individual worker’s ﬁle Notes: 13 Section two Checklist for individual worker’s ﬁle Category four The return to work process 4b Case notes Case notes are a legislative requirement in relation to rehabilitation. Section 107 of the Workers’ Compensation and Rehabilitation Regulation 2003 states accurate and objective case notes must be kept for each worker undertaking rehabilitation. Case notes must contain details of: a) b) c) all communications between the worker, the rehabilitation and return to work coordinator and other relevant parties and actions and decisions and reasons for actions and decisions. Case notes facilitate the rehabilitation of injured workers by maintaining a record of communications, actions and decisions. Case notes can also be useful if an injured worker decides to pursue common law action at a later date. Case notes can be an excellent source of information regarding how the employer (through the actions of the rehabilitation and return to work coordinator) and the injured worker met their obligations regarding rehabilitation. The intent of this category is to assess whether case notes for workplace rehabilitation are kept to a standard as outlined in the Workers’ Compensation and Rehabilitation Regulation 2003. Key elements Evidence of veriﬁcation - one or more may be used Case notes are kept Case notes on rehabilitation ﬁle Are signed and dated All entries signed; if electronic to be printed out, all entries initialled and each completed page signed Contain actions and decisions Clearly stated in case notes Contain reasons for actions and decisions Clearly stated in case notes Are objective and provide a chronological, accurate account of all communications with relevant parties Contain observed facts and relevant information Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category 4b under checklist for individual worker’s ﬁle Notes: 14 Section two Checklist for individual worker’s ﬁle Category four The return to work process 4c Suitable duties The intent of this category is to assess whether suitable duties are provided in consultation with all parties and provide a medically approved, safe and graduated return to work. Key elements Evidence of veriﬁcation - one or more may be used Where practicable, suitable duties are offered to all injured workers with medical certiﬁcation for partial incapacity Suitable duties plan Case notes Correspondence Suitable duties take into account worker’s medical condition and nature of their incapacity As shown on suitable duties plan Case notes or other documentation Suitable duties plans developed in consultation with treating medical practitioner Signature on suitable duties plan if required Record of case conference Case notes Suitable duties plans developed in consultation with injured worker Signature on suitable duties plan Record of case conference Case notes Where suitable duties are unfamiliar to injured worker, appropriate training and induction in the role and relevant safety procedures and supervision are provided Case notes Injured worker signs acknowledgement of receiving relevant training and induction Suitable duties are goal focused with tasks and restrictions considered in development Suitable duties plan shows goal, tasks, and restrictions Suitable duties are time limited and have a review date Suitable duties plan has a review date Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category 4c under checklist for individual worker’s ﬁle Notes: 15 Section two Checklist for individual worker’s ﬁle Category four The return to work process 4d Engaging rehabilitation service providers The intent of this category is to assess whether employers are ensuring rehabilitation service providers are able to meet some basic standards of service provision. By developing a service agreement that sets out the terms and expectations under which those services are to be provided, employers will be able to assess whether these terms and expectations have been met. Key elements Evidence of veriﬁcation - one or more may be used The role of rehabilitation providers is clear to all parties Request for services or referral clearly sets out what services are required, expected costs and the timeframes for delivery Rehabilitation service providers are evaluated against the request/referral Costs compared to estimates Progress reports/communication from providers are: • timely • easily understood Treatment providers contacted (with injured worker permission) to obtain updates on worker’s treatment and condition Case notes Fax Emails Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category 4d under checklist for individual worker’s ﬁle Notes: 16 Section two Checklist for individual worker’s ﬁle Category ﬁve Rehabilitation strategies for long term or seriously injured workers This category assesses whether appropriate assistance has been provided to seriously injured workers who are unable to return to work with their original employer. The National Occupational Health and Safety Commission (NOHSC 1995) states that when it is apparent that placement with the pre-injury employer is not possible, an alternative employer should be sought. The workers’ compensation insurer will be able to assist the employer in this situation. It should be recognised that placement or relocation away from colleagues and familiar work practices may add to the difﬁculties associated with returning to work. Referral to an appropriately qualiﬁed rehabilitation provider to provide placement assistance including vocational assessment, counselling and development of job seeking skills will assist with placement of these workers. Key elements Evidence of veriﬁcation - one or more may be used Redeployment considered when appropriate Offer of redeployment on injured worker ﬁle Referral to rehabilitation providers for vocational assessment, and job seeking skills training when appropriate (requires insurer approval for payment of costs) Referral on ﬁle Case notes Relevant documentation Retraining including host employer work trial and brief vocationally oriented training courses offered with realistic job prospects (requires insurer approval for payment of costs) Offer on ﬁle Tick if provided Comments/action required Add up the total number of ticks, enter in the box, then click here to enter your score in category ﬁve under checklist for individual worker’s ﬁle Notes: 17 Section two Checklist for individual worker’s ﬁle Category six Evaluation of workplace rehabilitation The intent of this category is to assess whether workplace rehabilitation programs continue to remain effective. The evaluation assesses the success rate of individual programs, costs and durations, problems or issues of concern, positive outcomes, and injured worker’s satisfaction. Key elements Evidence of veriﬁcation - one or more may be used Injured worker feedback in relation to workplace rehabilitation is sought during rehabilitation and following case closure Case notes/correspondence indicating evaluation sought from injured worker (may be telephone survey or other form of survey) Evaluation by injured worker on ﬁle Evaluations are collated and summarised Return to work status noted on individual worker ﬁle Case notes or ﬁle summary Rehabilitation of individual workers evaluated to highlight positive outcomes and any concerns Case notes, ﬁle reviews File summary Report Results collated and summarised to inform systems management Tick if provided Comments/action required Add up the total number of ticks, enter in the box then click here to enter your score in category six under checklist for individual worker’s ﬁle Notes: 18 The workplace rehabilitation environment Category one 0 Helping you get the measure of workplace rehabilitation to next category Category two 0 to next category Category three 0 to next category The self-assessment checklist was developed to provide a framework for employers wishing to assess their workplace rehabilitation systems. It is recommended that you use the overall score from the self-assessment checklist as a benchmark against which to compare future self-assessments. The higher the score, the better. But remember – be as objective as you can with your scoring to get the most out of the self-assessment process. The self-assessment checklist will help you to identify strengths and weaknesses in your workplace rehabilitation processes. It is an opportunity to identify areas where improvement can be made. Checklist for individual worker’s ﬁle Category one 0 to next category Category two 0 The self-assessment checklist should not be considered exhaustive and employers should consider adding additional indicators to customise the self-assessment checklist for their particular circumstances. Workplace rehabilitation is a dynamic ﬁeld and it is important to keep up to date with relevant changes in legislation that relate to the requirements for employers to provide rehabilitation. You should ensure that those responsible for coordinating rehabilitation in the workplace maintain regular contact with the workers’ compensation insurer’s case manager. To ﬁnd out more about getting assistance to improve workplace rehabilitation processes at your organisation, visit the employers section on the Q-COMP website (www.qcomp.com.au) or call Q-COMP on 1300 361 235 and ask to speak with a Senior Rehabilitation Advisor regarding any workplace rehabilitation enquiries you may have. to next category Category three 0 to next category Category four A B 0 C D back to category 4 to next category Category ﬁve 0 to next category Category six 0 Total Score 0 References Accident and Compensation Commission New Zealand 2000, The Self Management Programme for Accredited Employers, Partnership Programme, New Zealand. Comcare 1996, Return to Work: A Guide to Workers’ Compensation Case Management, Canberra. Rieve, Julia A, RN 2001, Best Practice in Case Management, The Case Manager, vol. January/February, pp. 36-37. National Occupational Health and Safety Commission 1995, Guidance Note for Best Practice Rehabilitation Management of Occupational Injuries and Disease, Canberra. Tasmanian Workers’ Compensation Authority 2002, Injury Map. Injury Management Assessment Program, Tasmania. Workcover New South Wales 2001, Self Insurers Injury Management Self Audit Tool, New South Wales. Case Management Society of America 2002, Standards of Practice for Case Management, Arkansas. 20